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Please print and bring your completed annual intake to your visit. 

If you are unable to complete the intake form prior to your appointment, please arrive 20 minutes early to fill it out.

Annual Intake Form

Rebound is partnered with MediCopy for form completion. Please submit your Disability, FMLA, or Paid Leave forms by using the button below.

For additional questions or form completion status follow-up, please call MediCopy at (866) 587-6274, ext. 213, or use the Live Chat option here.

Non-Workers' Compensation Form Submission